The Development for Intermediate Care in Health Service Network model, Roi Et Province

Abstract

Purposes : To explore the context, develop a care model, and evaluate the outcomes of this model in the health service network of Roi Et Province.

Study design : Action Research.

Materials and Methods: The target group included 30 multidisciplinary healthcare professionals from hospitals in Roi Et Province's health service network and 934 intermediate care patients. The study was conducted from October 2020 to September 2021. Data were collected through interviews, the Nemocare program, and analyzed using frequency, percentage, mean, standard deviation, and inferential statistics with a Paired t-test to compare the means.

Main findings : Roi Et Province revealed that intermediate care systems have been implemented across all 20 districts. There are 12 facilities with intermediate beds and 6 facilities with intermediate wards. The intermediate care model in Roi Et ’s health service network includes: 1) Developing intermediate care (IMC) services from hospitals to communities within the Roi Et health service network, 2) Creating an intermediate care manual and patient care guidelines, 3) Developing a training curriculum to enhance the capacity of personnel in intermediate care, and 4) Organizing meetings between hospital IT teams and the Roi Et Provincial Public Health Office to collaboratively design and implement the Nemo care program for systematic data collection and network design between hub hospitals and spoke hospitals. As a result of the research process, patient care has expanded to cover more patients. Patients received intermediate care rehabilitation and were followed up for six months, with 55.25% achieving a Barthel Index (BI) score of 20. Patient satisfaction with the model significantly increased after its development (Mean = 41.79, 95% CI = 35.06 – 48.53, p< .001). Moreover, 93.33% of the committee members exhibited a high level of participation.

Conclusion and Recommendations : This research led to an increase in intermediate care for the target group.